Interscalene Block Versus Serratus Posterior Superior Intercostal Plane Block for Arthroscopic Shoulder Surgery

December 16, 2025 updated by: Omer Doymus, Erzurum Regional Training & Research Hospital

Comparison of the Effectiveness of Interscalene Nerve Block and Serratus Posterior Superior Intercostal Plane Block in Patients Undergoing Arthroscopic Shoulder Surgery

This randomized controlled trial aims to compare the effectiveness of interscalene (ISB) and serratus posterior superior intercostal plane block (SPSIP) for postoperative analgesia in patients undergoing elective arthroscopic shoulder surgery. The primary outcome is total 24-hour opioid consumption. Secondary outcomes include pain scores, hemidiaphragmatic paresis incidence and severity, duration of analgesia, and changes in lung function. Participants are randomized into ISB or SPSIP groups; blocks are performed under ultrasound guidance. Postoperative pain is managed with patient controlled analgesia(PCA).

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Actual)

60

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Turkey (Türkiye)
    • Yakutiye
      • Erzurum, Yakutiye, Turkey (Türkiye), 25100
        • Erzurum Regional Training Research Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Agreeing to participate in the study
  • The American Society of Anesthesiologists I-III
  • Scheduled for elective unilateral arthroscopic shoulder surgery

Exclusion Criteria:

  • Refusal to participate in the study
  • Allergy to the medications to be used
  • History of serious heart, kidney or liver disease
  • Neurological deficits or neuropathy
  • History of anticoagulant use
  • Pre-existing operative respiratory dysfunction
  • Having chronic shoulder pain
  • Being about to undergo open surgery

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Quadruple

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Interscalene Brachial Plexus Block (ISB)
Patients will receive ISB under ultrasound guidance prior to arthroscopic shoulder surgery using 15 ml 0.25% bupivacaine.
Procedure: Interscalene Brachial Plexus Block (ISB)
Patients receive ultrasound-guided ISB before arthroscopic shoulder surgery. 15 ml of 0.25% bupivacaine is injected using a 22 Gauge 50 mm needle with posterior in-plane approach, targeting C5-C6 roots.
Experimental: Serratus Posterior Superior Intercostal Plane Block
Patients will receive SPSIP block under ultrasound guidance using 30 ml 0.25% bupivacaine
Procedure: Serratus Posterior Superior Intercostal Plane Block (SPSIP)
Patients receive ultrasound-guided SPSIP interfascial block in sitting position before surgery. Using a 22 Gauge 10 mm needle, 30 ml of 0.25% bupivacaine is injected between serratus posterior muscle and second rib.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Total 24-Hour Postoperative Opioid Consumption
Time Frame: 0-24 hours postoperatively
Total intravenous opioid consumption recorded for each patient during the first 24 hours after arthroscopic shoulder surgery, including any rescue analgesia administered.
0-24 hours postoperatively

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Incidence and Severity of Hemidiaphragmatic Paresis
Time Frame: Pre-block and 30 minutes post-block
Ipsilateral hemidiaphragmatic function evaluated by M-mode ultrasonography before block and 30 minutes after block completion. Paresis classified as none (<25% reduction), partial (25-75% reduction), or complete (>75% reduction or paradoxical movement).
Pre-block and 30 minutes post-block
Pulmonary Function Changes (FEV1)
Time Frame: Pre-block and 30 minutes post-block
Pulmonary function measured with bedside spirometry pre-block and 30 minutes post-block. Forced expiratory volume in 1 second (FEV1) recorded; each measurement performed three times and mean value used.
Pre-block and 30 minutes post-block
Pulmonary Function Changes (FVC)
Time Frame: Pre-block and 30 minutes post-block
Pulmonary function measured with bedside spirometry pre-block and 30 minutes post-block. Forced vital capacity (FVC) recorded; each measurement performed three times and mean value used.
Pre-block and 30 minutes post-block
Duration of Analgesia
Time Frame: Time interval from block completion to initiation of IV PCA fentanyl in each patient
0-24 hours post-block
Time interval from block completion to initiation of IV PCA fentanyl in each patient

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Erzurum Regional Training & Research Hospital

Investigators

  • Principal Investigator: Ömer Doymus, MD, Erzurum Regional Training & Research Hospital

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

December 1, 2024

Primary Completion (Actual)

December 1, 2025

Study Completion (Actual)

December 15, 2025

Study Registration Dates

First Submitted

December 16, 2025

First Submitted That Met QC Criteria

December 16, 2025

First Posted (Actual)

December 30, 2025

Study Record Updates

Last Update Posted (Actual)

December 30, 2025

Last Update Submitted That Met QC Criteria

December 16, 2025

Last Verified

December 1, 2025

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • SBUERZURUMSHOULDER

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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